Inflammation, Hypoxia, and Periodontal Breakdown: The Association Between Obstructive Sleep Apnea and Periodontitis; Results From a Systematic Review With Meta-Analysis

IF 2.4 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical and Experimental Dental Research Pub Date : 2026-07-19 DOI:10.1002/cre2.70401

Fariba Esperouz, Mauro Lorusso, Giuseppina Raffaella Giannini, Sara Ruffino, Elena D'Angelo, Michele Tepedino, Giuseppe Burlon, Francesca Sfondrini, Lucio Lo Russo, Domenico Ciavarella

{"title":"Inflammation, Hypoxia, and Periodontal Breakdown: The Association Between Obstructive Sleep Apnea and Periodontitis; Results From a Systematic Review With Meta-Analysis","authors":"Fariba Esperouz, Mauro Lorusso, Giuseppina Raffaella Giannini, Sara Ruffino, Elena D'Angelo, Michele Tepedino, Giuseppe Burlon, Francesca Sfondrini, Lucio Lo Russo, Domenico Ciavarella","doi":"10.1002/cre2.70401","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>This systematic review and meta-analysis aimed to evaluate the association between obstructive sleep apnea and periodontitis and to quantify the magnitude of this relationship based on the available evidence.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>A systematic literature search was conducted in PubMed, Scopus, and Web of Science up to November 2025, following PRISMA 2020 guidelines. Observational studies investigating the association between OSA and periodontitis in human adults were included. Study quality was assessed using the ROBINS-I tool. A random-effects meta-analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Additionally, Spearman correlation coefficients were synthesized when available.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Twenty-three studies were included in the qualitative synthesis, and 18 studies were eligible for quantitative analysis. The pooled meta-analysis demonstrated that OSA was significantly associated with an increased risk of periodontitis (OR = 2.22; 95% CI: 1.78–2.77), with moderate heterogeneity (<i>I</i><sup>2</sup> = 57.4%). Furthermore, a random-effects meta-analysis of correlation coefficients revealed a moderate positive association between OSA and periodontal disease severity (<i>r</i> = 0.39; 95% CI: 0.17–0.58). These findings were consistent across different populations and diagnostic approaches, particularly in studies using polysomnography for OSA assessment.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>The present meta-analysis provides evidence of a significant association between obstructive sleep apnea and periodontitis, with patients affected by OSA showing more than twice the risk of developing periodontal disease. Although causality cannot be established due to the observational nature of the included studies, shared inflammatory and microbiological pathways support a biologically plausible link. An interdisciplinary approach involving dental and sleep medicine professionals may be beneficial for early diagnosis and comprehensive management of both conditions.</p>\n </section>\n </div>","PeriodicalId":10203,"journal":{"name":"Clinical and Experimental Dental Research","volume":"12 4","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2026-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380817/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Dental Research","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/cre2.70401","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

This systematic review and meta-analysis aimed to evaluate the association between obstructive sleep apnea and periodontitis and to quantify the magnitude of this relationship based on the available evidence.

Methods

A systematic literature search was conducted in PubMed, Scopus, and Web of Science up to November 2025, following PRISMA 2020 guidelines. Observational studies investigating the association between OSA and periodontitis in human adults were included. Study quality was assessed using the ROBINS-I tool. A random-effects meta-analysis was performed to pool odds ratios (ORs) with 95% confidence intervals (CIs). Additionally, Spearman correlation coefficients were synthesized when available.

Results

Twenty-three studies were included in the qualitative synthesis, and 18 studies were eligible for quantitative analysis. The pooled meta-analysis demonstrated that OSA was significantly associated with an increased risk of periodontitis (OR = 2.22; 95% CI: 1.78–2.77), with moderate heterogeneity (I² = 57.4%). Furthermore, a random-effects meta-analysis of correlation coefficients revealed a moderate positive association between OSA and periodontal disease severity (r = 0.39; 95% CI: 0.17–0.58). These findings were consistent across different populations and diagnostic approaches, particularly in studies using polysomnography for OSA assessment.

Conclusions

The present meta-analysis provides evidence of a significant association between obstructive sleep apnea and periodontitis, with patients affected by OSA showing more than twice the risk of developing periodontal disease. Although causality cannot be established due to the observational nature of the included studies, shared inflammatory and microbiological pathways support a biologically plausible link. An interdisciplinary approach involving dental and sleep medicine professionals may be beneficial for early diagnosis and comprehensive management of both conditions.

Abstract Image

查看原文本刊更多论文

炎症、缺氧和牙周损伤：阻塞性睡眠呼吸暂停与牙周炎的关系荟萃分析的系统评价结果。

目的：本系统综述和荟萃分析旨在评估阻塞性睡眠呼吸暂停和牙周炎之间的关系，并根据现有证据量化这种关系的程度。方法：根据PRISMA 2020指南，系统检索截至2025年11月的PubMed、Scopus和Web of Science。调查阻塞性睡眠呼吸暂停和人类成人牙周炎之间关系的观察性研究包括在内。采用ROBINS-I工具评估研究质量。随机效应荟萃分析采用95%置信区间（ci）合并优势比（ORs）。此外，在可用的情况下，还合成了Spearman相关系数。结果：23项研究纳入定性综合，18项研究符合定量分析条件。综合荟萃分析显示，OSA与牙周炎风险增加显著相关（OR = 2.22; 95% CI: 1.78-2.77），具有中等异质性（I2 = 57.4%）。此外，相关系数的随机效应荟萃分析显示，OSA与牙周病严重程度存在中度正相关（r = 0.39; 95% CI: 0.17-0.58）。这些发现在不同的人群和诊断方法中是一致的，特别是在使用多导睡眠图评估OSA的研究中。结论：目前的荟萃分析提供了阻塞性睡眠呼吸暂停与牙周炎之间存在显著关联的证据，受OSA影响的患者患牙周病的风险是其两倍以上。尽管由于纳入研究的观察性，无法确定因果关系，但共同的炎症和微生物途径支持生物学上合理的联系。涉及牙科和睡眠医学专业人员的跨学科方法可能有利于这两种情况的早期诊断和综合管理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.